Browsing by Author "Dagnino Sepúlveda, Jorge"

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    75 años de la Facultad de Medicina de la Pontificia Universidad Católica de Chile
    (SOC MEDICA SANTIAGO, 2005) Grebe Barros, Gonzalo; Dagnino Sepúlveda, Jorge; Sánchez Díaz, Ignacio
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    El Trío de Viena. De la cocaína a la anestesia tópica
    (2011) Dagnino Sepúlveda, Jorge
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    [Nocturnal hypoxemia after abdominal surgery: associated factors and usefulness of oxygen therapy]
    (1997) Bugedo Tarraza, Guillermo; González Sotomayor, Julio; Cuadra F., Juan Carlos de la; Asenjo, C.; Gajardo, A.; Huechillán, I.; Añazco, R.; Torregrosa, S.; Dagnino Sepúlveda, Jorge
    Background: Postoperative nocturnal hypoxemia (PONH) is a main factor in the genesis of respiratory, cardiac and neurologic complications after surgery. Aim: To describe the phenomenon of PONH after elective laparoscopy and laparotomy, and to evaluate the usefulness of oxygen therapy in its prevention. Patients and methods: Fifteen elective patients (6 M, 9 F, 51 +/- 8 years old) scheduled for laparotomy (n = 8) or laparoscopy (n = 7) were studied. Ventilatory parameters and pulse oximetry were measured pre and postoperatively. Patients were randomly assigned to receive oxygen by nasal cannula either during the first or the second postoperative night. Results: PONH (SatO2 < 85) developed in seven patients (47%), of which four had undergone laparoscopic surgery. PONH was more frequent in mildly obese patients and those presenting preoperative hypoxemia (p = 0.03). Peak Flow was lower in patients presenting PONH (p = 0.04). In five patients, PONH was associated with significant tachycardia. Oxygen administration was associated with a higher SatO2 and prevented PONH in 6/7 patients. Conclusions: PONH is a common event in patients older than 40 years scheduled for open or laparoscopic abdominal surgery, and develops more frequently in those with preoperative nocturnal hypoxemia and greater ventilatory impairment. PONH can be prevented, most of the time, with oxygen administration.
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    Ondansetron and droperidol in the prevention of postoperative nausea and vomiting
    (Wiley, 1999) Bugedo Tarraza, Guillermo; González Sotomayor, Julio; Asenjo, C.; Cuadra F., Juan Carlos de la; Gajardo, A.; Castillo Fuenzalida, Luis; Muñoz L., Hernán; Dagnino Sepúlveda, Jorge
    We have performed a prospective, randomized, double-blind clinical study to assess the efficacy of ondansetron, droperidol, or both, in preventing postoperative emesis. We studied 242 patients undergoing biliary or gynaecological surgery under general anaesthesia. Shortly before induction of anaesthesia, patients received: saline i.v. (group 1, n=62); droperidol 2.5 mg i.v. (group 2, n=60); ondansetron 4 mg i.v. (group 3, n=57); or droperidol 2.5 mg with ondansetron 4 mg i.v. (group 4, n=63). Nausea occurred in 45%, 37%, 32% and 29% (P=0.234) and vomiting in 23%, 17%, 9% and 5% (P=0.016) of patients in groups 1, 2, 3 and 4, respectively, during the first 24 h. Groups 2 and 4 had greater sedation scores than group 1 during the first 3 h (P<0.01). We conclude that both droperidol and ondansetron showed a significant antiemetic effect, ondansetron was not significantly better than droperidol, and the combination of droperidol and ondansetron was better than droperidol but no better than ondansetron alone.
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    Ondansetron and droperidol in the prevention of postoperative nausea and vomiting
    (1999) Bugedo Tarraza, Guillermo; González Sotomayor, Julio; Asenjo, C.; Cuadra F., Juan Carlos de la; Gajardo, A.; Castillo Fuenzalida, Luis; Muñoz L., Hernán; Dagnino Sepúlveda, Jorge
    We have performed a prospective, randomized, double-blind clinical study to assess the efficacy of ondansetron, droperidol, or both, in preventing postoperative emesis. We studied 242 patients undergoing biliary or gynaecological surgery under general anaesthesia. Shortly before induction of anaesthesia, patients received: saline i.v. (group 1, n=62); droperidol 2.5 mg i.v. (group 2, n=60); ondansetron 4 mg i.v. (group 3, n=57); or droperidol 2.5 mg with ondansetron 4 mg i.v. (group 4, n=63). Nausea occurred in 45%, 37%, 32% and 29% (P=0.234) and vomiting in 23%, 17%, 9% and 5% (P=0.016) of patients in groups 1, 2, 3 and 4, respectively, during the first 24 h. Groups 2 and 4 had greater sedation scores than group 1 during the first 3 h (P<0.01). We conclude that both droperidol and ondansetron showed a significant antiemetic effect, ondansetron was not significantly better than droperidol, and the combination of droperidol and ondansetron was better than droperidol but no better than ondansetron alone.
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    Remifentanil Requirements During Sevoflurane Administration to Block Somatic and Cardiovascular Responses to Skin Incision in Children and Adults
    (2002) Muñoz, Hernán R.; Cortínez Fernandéz, Luis Ignacio; Altermatt Couratier, Fernando René; Dagnino Sepúlveda, Jorge
    Background: The authors found no studies comparing intraoperative requirements of opioids between children and adults, so they determined the infusion rate of remifentanil to block somatic (IR50) and autonomic response (ERBAR(50)) to skin incision in children and adults.", "Methods: Forty-one adults (aged 20-60 yr) and 24 children (aged 2-10 yr) undergoing lower abdominal surgery were studied. In adults, anesthesia induction was with sevoflurane during remifentanil infusion, whereas in children remifentanil administration was started after induction with sevoflurane. After intubation, sevoflurane was administered in 100% 02 and was adjusted to an ET% of 1 MAC-awake corrected for age at least 15 min before surgery. Patients were randomized to receive remifentanil at a rate ranging from 0.05 to 0.35 mug.kg(-1).min(-1) for at least 20 min before surgery. At the beginning of surgery, only the skin incision was performed, and the somatic and autonomic responses were observed. The somatic response was defined as positive with any gross movement of extremity, and the autonomic response was deemed positive with any increase in heart rate or mean arterial pressure equal to or more than 10% of preincision values. Using logistic regression, the IR50. and IRBAR(50) were determined in both groups of patients and compared with unpaired Student t test. A P value less than 0.05 was considered significant.", "Results: The IR50 +/- SD was 0.10 +/- 0.02 mug.kg(-1).min(-1) in adults and 0.22 +/- 0.03 mug.kg(-1).min(-1) in children (P < 0.001). The IRBAR50 SD was 0.11 &PLUSMN; 0.02 μg.kg(-1).min(-1) in adults and 0.27 &PLUSMN; 0.06 μg.kg(-1).min(-1) in children (P < 0.001).", "Conclusions: To block somatic and autonomic responses to surgery, children require a remifentanil infusion rate at least twofold higher than adults.
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    Revitalising medical education: The School of Medicine at the Pontificia Universidad Católica de Chile
    (2008) Sánchez Díaz, Ignacio; Riquelme Pérez, Arnoldo; Moreno Bolton, Rodrigo; Mena Concha, Beltrán; Dagnino Sepúlveda, Jorge; Grebe Barros, Gonzalo
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